The Effectiveness of the Combination Therapy with biologic DMARDS in Rheumatoid Arthritis
Keywords:
Rheumatoid arthritis, adalimumab, methotrexate, ACR20, ACR50, ACR70Abstract
This observational cohort study assessed the efficacy and safety of adalimumab and methotrexate combination therapy in patients with rheumatoid arthritis (RA) who had an inadequate response to methotrexate monotherapy. Patients were divided into three groups. The primary outcome was the change in the Disease Activity Score based on 28 joints (DAS28) from baseline to 6 months. Secondary outcomes included the American College of Rheumatology (ACR) 20, 50, and 70 responses, changes in the Health Assessment Questionnaire-Disability Index (HAQ-DI) scores, and radiographic progression assessed using the modified Sharp/van der Heijde score (mTSS). Results showed that the combination of adalimumab and methotrexate was significantly superior to methotrexate monotherapy in achieving clinically significant responses (ACR20, ACR50, and ACR70) over nine months of treatment. Group IB, receiving a higher dose of methotrexate, exhibited slightly better clinical improvement rates than Group IA, although the difference was not statistically significant. By nine months, 88.9% of patients in Group IB achieved an ACR20 response, compared to 74.2% in Group IA and 46% in the comparison group. Similar trends were observed for ACR50 and ACR70 responses. The study suggests that the combination of adalimumab and methotrexate is clinically superior to methotrexate monotherapy in the treatment of RA, with a higher methotrexate dose potentially leading to better outcomes.
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